© 2004 by Oxford University Press
© 2004 Oxford University Press
ARTICLE |
Lung Cancer Rates in Men and Women With Comparable Histories of Smoking
Affiliations of authors: School of Population Health, University of Queensland, Brisbane, Queensland, Australia (CB); Department of Social Medicine, University of Bristol, Bristol, England (CB); Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA (DF, FES, BAR, GAC); American Cancer Society, Atlanta, GA (MT); Departments of Environmental Health (FES), Epidemiology (EH, GAC), and Biostatistics (BAR), and Harvard Center for Cancer Prevention (GAC), Harvard School of Public Health, Boston
Correspondence to: Diane Feskanich, ScD, Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Ave., Boston, MA 02115 (e-mail: diane.feskanich{at}channing.harvard.edu)
Background: Recent case–control studies suggest that, given equal smoking exposure, women may have a higher relative risk of developing lung cancer than men. Despite prospective data that conflict with this hypothesis, mechanistic studies to find a biologic basis for a sex difference continue. Methods: We addressed the hypothesis directly by analyzing prospective data from former and current smokers in two large cohorts—the Nurses’ Health Study of women and the Health Professionals Follow-up Study of men. We calculated incidence rates and hazard ratios of lung cancer in women compared with men, adjusting for age, number of cigarettes smoked per day, age at start of smoking, and time since quitting, using Cox proportional hazards models. We also reviewed published results from prospective analyses. Results: From 1986 through 2000, 955 and 311 primary lung cancers were identified among 60 296 women and 25 397 men, respectively, who ranged in age from 40 to 79 years. Incidence rates per 100 000 person-years for women and men were 253 and 232, respectively, among current smokers and 81 and 73, respectively, among former smokers. The hazard ratio in women ever smokers compared with men was 1.11 (95% confidence interval = 0.95 to 1.31). Six published prospective cohort studies allowed assessment of comparative susceptibility to lung cancer by sex. None supported an excess risk of lung cancer for women. Conclusions: Women do not appear to have a greater susceptibility to lung cancer than men, given equal smoking exposure. Research should be focused on enhancing preventive interventions for all.
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Correspondence about this Article
- Re: Are Women More Susceptible to Lung Cancer?
- Harvey A. Risch and Anthony B. Miller
J Natl Cancer Inst 2004 96: 1560.[Extract] [Full Text] [PDF]
- RESPONSE: Re: Are Women More Susceptible to Lung Cancer?
- William J. Blot and Joseph K. McLaughlin
J Natl Cancer Inst 2004 96: 1560-1561.[Extract] [Full Text] [PDF]
- RESPONSE: Re: Are Women More Susceptible to Lung Cancer?
- Chris Bain
J Natl Cancer Inst 2004 96: 1561.[Extract] [Full Text] [PDF]
Editorial about this Article
- Are Women More Susceptible to Lung Cancer?
- William J. Blot and Joseph K. McLaughlin
J Natl Cancer Inst 2004 96: 812-813.[Extract] [Full Text] [PDF]
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